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NPI Code Detail

MEDICARE: JOSEPH L. DONNELLY III MD

MEDICARE: JOSEPH L. DONNELLY III MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207PE0004XEmergency Medical Services (Emergency Medicine) PhysicianK1418TX
2207P00000XEmergency Medicine PhysicianK1418TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1750327995
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH L. DONNELLY III MD
Provider Business Mailing Address
First Line : 3816 PAPPYS WAY
Second Line :
City : AUSTIN
State : TX
Zip : 78730-1523
Country : US
Telephone Number : 512-342-6800
Fax Number :
Provider Business Practice Location Address
First Line : 12221 N MO PAC EXPY
Second Line :
City : AUSTIN
State : TX
Zip : 78758-2415
Country : US
Telephone Number : 512-901-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2006
Last Update Date : 05/13/2010

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